To investigate the effects of Long's Manipulation (LM) for patient with chronic mechanical neck pain : a randomized control trial

Abstract

Introduction: Neck pain is a common health problem recognized as a significant source of disability in the general population. Spinal manipulation (SM) has been suggested to be an effective intervention for neck pain. Long's manipulation (LM) is a representative Chinese manipulation approach which incorporates manipulation techniques and traditional Chinese massage (TCM) techniques and is widely utilized to treat various neck disorders in Chinese Mainland. However, little research has investigated its efficacy in the management of chronic mechanical neck pain. This randomized controlled trial (RCT) intended to investigate the relative effectiveness of LM by comparing to TCM on patients with chronic mechanical neck pain. Method: A total of 63 patients were recruited with a diagnosis of chronic mechanical neck pain by medical doctor. An independent assessor who was blinded to the grouping of the patients performed baseline assessment. Patients were randomly assigned to either LM group or TCM group by using computer-generated minimization method taking into account of age, gender, and degree of disability resulting from the neck pain. Both groups received massage therapy and LM group received extra LM to cervical spine. Patients attended 8 sessions (20 minutes/session) with a frequency of one session every three days. Outcome measures included Chinese version Northwick Park Neck Pain Questionnaire (NPQ), numerical pain rating scale (NPRS), patient perceived satisfaction of care (11-point scale), craniovertebral angle (CV angle) and cervical range of motion (CROM). Patients were assessed by the independent assessor at baseline, immediate after 8 sessions of treatment and 3 months follow-up. Results: Compared to TCM group, patients in LM group achieved better improvement in NPQ and NPRS immediate after treatment and up to 3-month follow-up. Patients in the LM group also demonstrated greater satisfaction of care than that in the TCM group at the subsequent follow-ups. LM group showed significant increase in CV angle throughout the study period, however, there is no statistically significant difference between the two groups. Patients in LM group demonstrated significant increase in most CROM, but the improvement is not superior to that of TCM group. Conclusion: This study shows that LM could produce greater effects than TCM in relieving pain and improving disability in the management of patients with chronic mechanical neck pain.